Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | ||
N | 225400000X | Rehabilitation Practitioner |
NPI | 1003009697 |
---|---|
Provider Name | Lucy Serrano |
First Address | Los Angeles, CA 90059-3052 |
Second Address | Los Angeles, CA 90059-3052 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2007 |
Last Update Date | 05/11/2014 |